Mounting evidence has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates ...attributable to various cancers. A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes. The purpose of this statement is to review current knowledge related to the association between CRF and health outcomes, increase awareness of the added value of CRF to improve risk prediction, and suggest future directions in research. Although the statement is not intended to be a comprehensive review, critical references that address important advances in the field are highlighted. The underlying premise of this statement is that the addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and to encourage lifestyle-based strategies designed to reduce cardiovascular risk. These opportunities must be realized to optimize the prevention and treatment of cardiovascular disease and hence meet the American Heart Association’s 2020 goals.
Groupers are a valuable fishery resource of reef ecosystems and are among those species most vulnerable to fishing pressure because of life history characteristics including longevity, late sexual ...maturation and aggregation spawning. Despite their economic importance, few grouper fisheries are regularly monitored or managed at the species level, and many are reported to be undergoing declines. To identify major threats to groupers, the International Union for Conservation of Nature (IUCN) Red List criteria were applied to all 163 species. Red List assessments show that 20 species (12%) risk extinction if current trends continue, and an additional 22 species (13%) are considered to be Near Threatened. The Caribbean Sea, coastal Brazil and Southeast Asia contain a disproportionate number of Threatened species, while numerous poorly documented and Near Threatened species occur in many regions. In all, 30% of all species are considered to be Data Deficient. Given that the major threat is overfishing, accompanied by a general absence and/or poor application of fishery management, the prognosis for restoration and successful conservation of Threatened species is poor. We believe that few refuges remain for recovery and that key biological processes (e.g. spawning aggregations) continue to be compromised by uncontrolled fishing. Mariculture, through hatchery‐rearing, increases production of a few species and contributes to satisfying high market demand, but many such operations depend heavily on wild‐caught juveniles with resultant growth and recruitment overfishing. Better management of fishing and other conservation efforts are urgently needed, and we provide examples of possible actions and constraints.
The authors prospectively assessed anxiety, depression, and behavior in children with standard-risk acute lymphoblastic leukemia (SR-ALL) during the first year of therapy and identified associated ...risk factors.
A cohort study was performed of 159 children (aged 2 years-9.99 years) with SR-ALL who were enrolled on Children's Oncology Group protocol AALL0331 at 31 sites. Parents completed the Behavior Assessment System for Children, the General Functioning Scale of the Family Assessment Device, and the Coping Health Inventory for Parents at approximately 1, 6, and 12 months after diagnosis.
Overall, mean scores for anxiety, depression, aggression, and hyperactivity were similar to population norms. However, more children scored in the at-risk/clinical range for depression than the expected 15% at 1 month (21.7%; P= .022), 6 months (28.6%; P< .001), and 12 months (21.1%; P= .032). For anxiety, more children scored in the at-risk/clinical range at 1 month (25.2% vs 15%; P= .001), but then reverted to expected levels. On adjusted analysis, unhealthy family functioning was found to be predictive of anxiety (odds ratio OR, 2.24; P= .033) and depression (OR, 2.40; P= .008). Hispanic ethnicity was associated with anxiety (OR, 3.35; P= .009). Worse physical functioning (P= .049), unmarried parents (P= .017), and less reliance on social support (P= .004) were found to be associated with depression. Emotional distress at 1 month predicted anxiety (OR, 7.11; P= .002) and depression (OR, 3.31; P= .023) at 12 months.
Anxiety is a significant problem in a subpopulation of patients with SR-ALL immediately after diagnosis, whereas depression remains a significant problem for at least 1 year. Children of Hispanic ethnicity or those with unhealthy family functioning may be particularly vulnerable. These data suggest that clinicians should screen for anxiety and depression throughout the first year of therapy.
Key message
Coordinated association and linkage mapping identified 25 grain quality QTLs in multiple environments, and fine mapping of the
Wx
locus supports the use of high-density genetic markers in ...linkage mapping.
There is a wide range of end-use products made from cereal grains, and these products often demand different grain characteristics. Fortunately, cereal crop species including sorghum
Sorghum bicolor
(L.) Moench contain high phenotypic variation for traits influencing grain quality. Identifying genetic variants underlying this phenotypic variation allows plant breeders to develop genotypes with grain attributes optimized for their intended usage. Multiple sorghum mapping populations were rigorously phenotyped across two environments (SC Coastal Plain and Central TX) in 2 years for five major grain quality traits: amylose, starch, crude protein, crude fat, and gross energy. Coordinated association and linkage mapping revealed several robust QTLs that make prime targets to improve grain quality for food, feed, and fuel products. Although the amylose QTL interval spanned many megabases, the marker with greatest significance was located just 12 kb from
waxy
(
Wx
), the primary gene regulating amylose production in cereal grains. This suggests higher resolution mapping in recombinant inbred line (RIL) populations can be obtained when genotyped at a high marker density. The major QTL for crude fat content, identified in both a RIL population and grain sorghum diversity panel, encompassed the
DGAT1
locus, a critical gene involved in maize lipid biosynthesis. Another QTL on chromosome 1 was consistently mapped in both RIL populations for multiple grain quality traits including starch, crude protein, and gross energy. Collectively, these genetic regions offer excellent opportunities to manipulate grain composition and set up future studies for gene validation.
Standard risk acute lymphoblastic leukemia (SR‐ALL) has high cure rates, but requires 2–3 years of therapy. We aimed to (i) prospectively evaluate health‐related quality of life (HRQOL) during and ...after SR‐ALL therapy, and (ii) identify associated predictors. Parents of 160 SR‐ALL patients enrolled on Children's Oncology Group (COG) therapeutic trial AALL0331 at 31 sites completed the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales (physical, emotional and social functioning) and Family Assessment Device‐General Functioning (FAD‐GF) at 1, 6 and 12 months after diagnosis, and 3 months post‐therapy. Mean PedsQL scores in physical, emotional and social functioning were impaired 1 month after diagnosis but steadily improved. Three months post‐therapy, impaired physical and social functioning was observed in 27.8 and 25.8% of patients, respectively. In repeated‐measures analysis, problematic family functioning predicted emotional (OR = 1.85, 95% CI 1.03–3.34) and social (OR = 1.99, 95% CI 1.21–3.27) impairment. Larger household size was associated with social impairment (OR = 1.21, 95% CI 1.02–1.45). Adverse neurological event(s) during therapy predicted post‐therapy physical (OR = 5.17, 95% CI 1.61–16.63) and social (OR = 8.17, 95% CI 1.19–56.16) impairment. HRQOL 1 month after diagnosis was not predictive of HRQOL 3 months after therapy completion. In conclusion, children with SR‐ALL experience considerable impairment in HRQOL at the end of induction, but rapidly improve. However, many still experience physical and social impairment 3 months post‐therapy, suggesting a role for continued family and physical functioning support. Longer follow‐up is needed to determine if post‐therapy deficits change over time.
What's new?
More than 90 percent of children with standard‐risk acute lymphoblastic leukemia (SR‐ALL) survive the disease, though treatment is intense and can last as many as three years. This prospective evaluation of health‐related quality of life (HRQOL) of children during and after therapy for SR‐ALL shows that a significant proportion of children suffer from persistent physical and social impairment three months post‐therapy. Risk factors for impairment included certain family factors and adverse neurological events experienced during therapy. Further elucidation of these predictors could help clinicians identify patients at risk for impaired HRQOL and inform interventions to improve HRQOL.
We reviewed all genomic epidemiology studies on COVID-19 in long-term care facilities (LTCFs) that had been published to date. We found that staff and residents were usually infected with identical, ...or near identical, SARS-CoV-2 genomes. Outbreaks usually involved one predominant cluster, and the same lineages persisted in LTCFs despite infection control measures. Outbreaks were most commonly due to single or few introductions followed by a spread rather than a series of seeding events from the community into LTCFs. The sequencing of samples taken consecutively from the same individuals at the same facilities showed the persistence of the same genome sequence, indicating that the sequencing technique was robust over time. When combined with local epidemiology, genomics allowed probable transmission sources to be better characterised. The transmission between LTCFs was detected in multiple studies. The mortality rate among residents was high in all facilities, regardless of the lineage. Bioinformatics methods were inadequate in a third of the studies reviewed, and reproducing the analyses was difficult because sequencing data were not available in many facilities.
Systematic reviews should provide balanced assessments of benefits and harms, while focusing on the most important outcomes. Selection of harms to be reviewed can be a challenge due to the potential ...for large numbers of diverse harms.
A workgroup of methodologists from Evidence-based Practice Centers (EPCs) developed consensus-based guidance on selection and prioritization of harms in systematic reviews. Recommendations were informed by a literature scan, review of Evidence-based Practice Center reports, and interviews with experts in conducting reviews or assessing harms and persons representing organizations that commission or use systematic reviews.
Ten recommendations were developed on selection and prioritization of harms, including routinely focusing on serious as well as less serious but frequent or bothersome harms; routinely engaging stakeholders and using literature searches and other data sources to identify important harms; using a prioritization process (formal or less formal) to inform selection decisions; and describing the methods used to select and prioritize harms.
We provide preliminary guidance for a more structured approach to selection and prioritization of harms in systematic reviews.
The animal industry is a major sector of agriculture in the southeastern United States, but a large deficit exists in regional feed grains needed to support the industry. An increase in production of ...sorghum Sorghum bicolor (L.) Moench, a water‐ and nutrient‐use‐efficient cereal, on marginal lands could lead to an alternative crop option for growers and reduce the current grain deficit. Quantitative trait locus (QTL) mapping of grain yield components in two sorghum biparental recombinant inbred line (RIL) populations was performed to better understand the genetic basis of grain yield and characterize these traits in a marginal environment. A more robust knowledge of the genetics underlying these complex traits could provide insights into molecular breeding strategies that aim to increase genetic gain. Specific yield traits investigated were grain number per primary panicle (GNP), 1000‐grain weight (TGW), and grain yield per primary panicle (YPP). Two‐year phenotyping in the South Carolina coastal plain revealed greater than threefold variation for both GNP and YPP, whereas TGW variation was just above twofold in both RIL families. There were 16 total yield trait QTL identified across both populations. Of the 16, eight QTL colocated with previously published QTL for yield‐related traits, including a QTL on chromosome 1 that was significant for all three grain yield components. A novel QTL for TGW was identified on chromosome 5 that explained >21% of the phenotypic variance observed in one RIL population. This QTL and the seven additional novel QTL identified in this study provide new targets for grain yield improvement in sorghum.
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